The symptoms of panic disorder in children are similar to those seen in adults, including sudden fear and extreme physical discomfort without a clear environmental trigger. Children reporting on their own symptoms are more likely to talk about the physical, rather than emotional, aspects of panic disorder, and this can make it harder to diagnose. Historically, panic disorder in children has been underdiagnosed due to beliefs that children don't get it or to confusion about how the symptoms present. Children with signs of panic disorder should be evaluated by a psychologist or psychiatrist.
The physical symptoms of panic disorder in children include an elevated heart rate and feeling that the heart is pounding, as well as hot flashes, sweating, shaking, nausea, and dizziness. Emotionally, children may experience fear and can disassociate, feeling like the world around them is not real. If these responses occur in response to a specific and predictable exposure to something, the child has a phobia, not panic disorder. If they appear random, it is a sign of panic disorder. Children can have panic attacks at home, at school, or in settings like the doctor's office. They may express anxiety about an event or situation, but are more likely to talk about feeling physically unwell.
Panic disorder in children can also come with comorbidities, just as it can in adults. Children can have depression, bipolar disorder, and other psychiatric conditions. These may complicate the panic disorder and it is important for children to be thoroughly evaluated to check for signs of other psychiatric issues. Simply diagnosing a child with panic disorder may not be enough, and failure to provide treatment for other conditions may result in a worsening of symptoms.
Treatments for panic disorder in children often start with medications to help children manage their panic attacks. Therapy, where the patient talks with a mental health professional, can also be beneficial. The therapist can identify and explore specific sources of anxiety, as well as providing children with coping tips and suggestions like breathing exercises. Children may also need to be accommodated at school with things like a quiet room to calm down in when a panic attack appears to be developing.
Panic disorder in children can continue into adolescence and adulthood, and it is very important for people to get treatment so it does not become disabling. Untreated panic disorder can interfere with performance at work or school, and may also be associated with physical ill health such as weight loss caused by feeling too anxious to eat.
